| NPI | 1417394404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: AR E-12177) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR E12177) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 574209) | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2024-05-14 |